Is It Colon Cancer? Symptoms and Concerns - Gastroenterology and Hepatology

Q: Is It Colon Cancer? Symptoms and Concerns

Hello, Xiao Zheng： If you frequently experience bowel movement issues and suspect blood in your stool, it is advisable to undergo a colonoscopy or a sigmoidoscopy combined with lower gastrointestinal imaging. <br>This is because the accuracy and specificity of fecal occult blood

Is it colorectal cancer?

Hello, Doctor: My daughter is 26 years old and has no family history of cancer.
She was diagnosed with irritable bowel syndrome during her three years in high school.
In early 2003, she had a stool occult blood test due to greenish stools, which was negative.
I would like to ask the following: 1.
On the night of August 1st, she suddenly developed a high fever (38.7°C) and went to the emergency room.
Tests were conducted (blood, urine, chest X-ray, but no stool sample was collected).
The first three tests were generally normal, except for a slightly elevated WBC count in the blood.
She was diagnosed with gastroenteritis and has been experiencing diarrhea (loose stools) three times a day for the past two days.
The night before the fever (July 31st), she ate two large pieces of braised carrots, and since August 1st until today (August 3rd), she has noticed reddish chunks resembling carrots in her loose stools.
Shouldn't she have eliminated all the food from the previous days with three bowel movements a day? Or is it possible that due to intestinal inflammation, there is retained stool that cannot be expelled? (But retained stool is usually associated with constipation, right?) I am very confused and worried.
Could this be a sign of cancer??????????? 2.
Due to severe picky eating in the past, I have never consumed carrots, tomatoes, and similar foods.
However, I recently learned about their nutritional value and have been forcing myself to eat them! Yet, I have noticed that almost every time I eat these foods, the next day I find two or three reddish spots that look like blood when wiping after a bowel movement.
Sometimes they are dot-like, sometimes granular, and sometimes in patches.
I consulted a proctologist, who said I have mild internal hemorrhoids (at the 7 o'clock position).
During the consultation, I mentioned that I had experienced "constipation" for the past three years (I can pass stool but always feel incomplete), and he said that does not count as constipation.
He then insisted on scheduling a time for a sigmoidoscopy to check for polyps?! Three years ago, I felt my bowel movements were irregular, possibly due to my daytime work and nighttime studies, but since graduating this year, I have not experienced any irregularities! I am very scared...
Is my main complaint serious enough to warrant such an invasive examination? Thank you.

Xiao Zheng, 20~29 year old female. Ask Date: 2003/08/03

Dr. Cai Junyan reply Gastroenterology and Hepatology

Hello, Xiao Zheng: If you frequently experience bowel movement issues and suspect blood in your stool, it is advisable to undergo a colonoscopy or a sigmoidoscopy combined with lower gastrointestinal imaging.
This is because the accuracy and specificity of fecal occult blood tests are relatively poor.
Gastroenterology, Dr.
Cai Junyan.

Reply Date: 2003/08/03

More Info

Understanding the concerns surrounding colon cancer, especially in a young individual like your daughter, is crucial. Given her age (26 years) and the absence of a family history of cancer, the likelihood of developing colon cancer is relatively low. However, it is essential to address her symptoms and the findings from her medical evaluations.

1. Symptoms and Recent Health Issues: Your daughter experienced a sudden high fever and diarrhea, which led to a diagnosis of gastroenteritis. The presence of red-colored material in her stool, particularly after consuming red carrots, raises questions. It is possible that the red color observed in her stool is simply undigested food, particularly if she has recently increased her intake of foods she previously avoided. Gastrointestinal inflammation can sometimes lead to changes in stool appearance, but it does not necessarily indicate cancer.
The fact that she has been experiencing diarrhea (three times a day) could also be a result of her gastrointestinal tract reacting to the infection or inflammation. It is not uncommon for stool to retain some food particles for a short period, especially if the digestive system is under stress. The concern about "宿便" (stool retention) typically relates to constipation, which does not seem to be the case here.

2. Rectal Bleeding and Internal Hemorrhoids: The presence of red spots or streaks in the stool after eating certain foods could be attributed to her mild internal hemorrhoids, as diagnosed by the rectal specialist. Hemorrhoids can cause minor bleeding, especially after bowel movements, and are common, particularly in individuals who have experienced constipation or straining. The doctor’s recommendation for a sigmoidoscopy is a prudent step to rule out any polyps or other abnormalities in the colon, especially given her history of gastrointestinal issues.

3. Concerns About Cancer: While it is understandable to be concerned about cancer, especially with symptoms like rectal bleeding, it is essential to consider the context. Colon cancer is rare in individuals under 50, particularly without a family history or other risk factors. The symptoms your daughter is experiencing are more likely related to benign conditions, such as hemorrhoids or dietary changes, rather than cancer.
4. Importance of Follow-Up: It is wise to follow through with the recommended sigmoidoscopy. This procedure is less invasive than a full colonoscopy and can provide valuable information about the health of the colon. Early detection of any potential issues, including polyps, can significantly improve outcomes.

5. Dietary Considerations: Since your daughter has a history of selective eating, it is beneficial that she is incorporating more nutritious foods into her diet. A balanced diet rich in fiber can help maintain healthy bowel function and potentially reduce the risk of gastrointestinal issues.

In conclusion, while it is natural to worry about serious conditions like cancer, the symptoms your daughter is experiencing are more likely related to benign gastrointestinal issues. The recommended sigmoidoscopy will provide clarity and peace of mind. Encourage her to maintain a healthy diet, stay hydrated, and follow up with her healthcare provider regarding any ongoing symptoms. Regular check-ups and being attentive to changes in her health will be key in managing her well-being.

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